Thoracic Spinal Anesthesia With Erector Spinae Plane Block Versus Conscious Sedation for Medical Thoracoscopy: A...

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Pain Management

Background:

• Medical thoracoscopy (MT) often results in significant postoperative pain and morbidity.
• Effective pain management is crucial for improving patient recovery after MT.

Purpose of the Study:

• To compare the efficacy of thoracic spinal anesthesia (TSA) combined with erector spinae plane block (ESPB) versus conscious sedation for MT.
• To evaluate patient-centered outcomes, including quality of recovery and postoperative analgesia.

Main Methods:

• A non-randomized prospective comparative pilot study involving 36 patients undergoing MT.
• Patients were alternately assigned to receive either TSA with ESPB or conscious sedation (fentanyl, midazolam, local lignocaine).
• Primary outcome was quality of recovery (QoR-15 score); secondary outcomes included time to first analgesic, 24-hour opioid consumption, and procedure duration.

Main Results:

• The TSA with ESPB group showed significantly higher Quality of Recovery-15 scores (112.83 ± 27.16 vs. 65.78 ± 22.13, p=0.0001).
• Time to first analgesic was longer in the ESPB group (11.69 ± 6.93 hours vs. 2.39 ± 1.69 hours, p=0.0001).
• Opioid consumption was lower (50 ± 10 vs. 75 ± 15, p=0.001), and procedure duration was shorter (64.72 vs. 93.89 minutes, p=0.0001) in the ESPB group.

Conclusions:

• Thoracic spinal anesthesia combined with erector spinae plane block is a safe and effective anesthetic technique for medical thoracoscopy.
• This combination improves quality of recovery, enhances postoperative analgesia, shortens procedure duration, and reduces perioperative morbidity.